Score for the Targeting of Atrial Fibrillation: A New Approach to Diagnosing Paroxysmal Atrial Fibrillation
Score for the Targeting of Atrial Fibrillation: A New Approach to Diagnosing Paroxysmal Atrial Fibrillation
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DOI：
10.1159/000323852
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发表时间：
2011-01-01
影响因子：
2.9
通讯作者：
Lachaud, Sylvain
中科院分区：
文献类型：
--
作者：
Suissa, Laurent;Mahagne, Marie Helene;Lachaud, Sylvain
背景与目的：缺血性脑卒中后阵发性心房颤动（PAF）的检测具有挑战性。有几种方法可以提高PAF的检出率，但首先有必要确定有风险的患者亚组。在之前的一项研究中，我们建立了一个预测卒中患者心房颤动（AF）的临床放射学评分。本研究的目的是验证PAF患者的评分。方法：对我院脑卒中科连续收治的500例缺血性脑卒中患者进行检查。对每个有或没有房颤的患者进行STAF（房颤靶向评分）的盲法评估。首先，我们通过比较初步研究和目前研究中受试者工作特征曲线下的区域来建立STAF表现的可重复性。其次，比较不同类型AF的受者工作特征曲线下面积，验证STAF对隐匿性AF的预测价值。第三，计算最佳阈值。结果：房颤145例，其中阵发性房颤占45%。在受试者工作特征曲线下，初步队列区域与前瞻性队列区域的评分表现无显著差异（p = 0.192）。这证实了工作人员业绩的可重复性。PAF组受者工作特征曲线下面积为0.907，而永久性AF组为0.911 （p = 0.906）。STAF对永久性房颤和阵发性房颤的诊断价值相同。对于PAF， STAF >= 5的敏感性为91%，特异性为77%。结论：由于其可重复性和预测价值，staff可被神经学家用作隐匿性房颤新诊断策略的一部分。版权所有(C) 2011 S. kager AG, Basel
Background and Purpose: Detecting paroxysmal atrial fibrillation (PAF) after ischaemic stroke is challenging. There are several methods to increase the detection rate of PAF, but it is first necessary to identify subgroups of patients at risk. In a previous study, we established a clinicoradiologic score that predicts atrial fibrillation (AF) in stroke patients. The purpose of the present study is to validate this score specifically for PAF patients. Methods: 500 consecutive ischaemic stroke patients were examined in our stroke unit. A blind evaluation of the STAF (score for the targeting of atrial fibrillation) was performed for each patient with or without AF. Firstly, we established the reproducibility of the STAF performance by comparing areas under the receiver operating characteristic curves in the preliminary and present studies. Secondly, to validate the predictive value of the STAF in occult AF, areas under the receiver operating characteristic curves were compared for each type of AF. Thirdly, the best threshold value was calculated. Results: AF was detected in 145 cases including 45% of paroxysmal forms. There is no significant score performance difference (p = 0.192) between the preliminary and prospective cohort areas under the receiver operating characteristic curves. This confirms the reproducibility of STAF performance. The area under the receiver operating characteristic curve for the PAF group was 0.907 versus 0.911 for the permanent AF group (p = 0.906). The diagnostic value of the STAF is as good in permanent as paroxysmal AF. In PAF, a STAF >= 5 has a sensitivity of 91% and a specificity of 77%. Conclusions: Due to its reproducibility and predictive value, the STAF can be used by neurologists as part of a novel diagnostic strategy for occult AF. Copyright (C) 2011 S. Karger AG, Basel